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Trial registered on ANZCTR
Registration number
ACTRN12617001535369
Ethics application status
Approved
Date submitted
19/10/2017
Date registered
6/11/2017
Date last updated
6/11/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Are dehydration and diuretic use more commonly associated with falls in frail, elderly patients compared with the robust elderly?
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Scientific title
Comparison of the incidence of dehydration and diuretic use among both frail older and robust older patients who present to the Emergency Department with falls
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Secondary ID [1]
293172
0
nil known
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Universal Trial Number (UTN)
U1111-1204-0109
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Trial acronym
AMM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
polypharmacy
305157
0
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ageing
305158
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frailty
305160
0
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falls
305233
0
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Condition category
Condition code
Injuries and Accidents
304539
304539
0
0
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Other injuries and accidents
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Patients' demographic, clinical, medications and falls information collected: Edmonton frail scale calculated for patients presenting within a time period of 12 months
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Intervention code [1]
299420
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Not applicable
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Comparator / control treatment
Study internally controlled as participants whose Edmonton frail scale result indicated that they were not frail were used as a comparator group to the 'frail' participants
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Control group
Active
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Outcomes
Primary outcome [1]
303714
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calculation of proportion of frail participants who were taking diuretics upon presentation using data collected from patients' medical records. Frailty was assessed using the Edmonton Frail Scale: participants were deemed to be frail if their score was greater than, or equal to 8.
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Assessment method [1]
303714
0
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Timepoint [1]
303714
0
Calculated upon presentation to ED
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Primary outcome [2]
303724
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Calculation of proportion of frail participants who were dehydrated at presentation. Frailty was assessed using the Edmonton Frail Scale: participants were deemed to be frail if their score was greater than, or equal to 8. Dehydration was defined as either a serum sodium concentration greater than 145 mEq/L or a serum urea:creatinine ratio greater than 100.
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Assessment method [2]
303724
0
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Timepoint [2]
303724
0
Assessed at time of presentation to ED
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Primary outcome [3]
303725
0
calculation of proportion of frail participants who taking diuretic medication and were dehydrated at presentation. Information on diuretic usage was gained from patients medical records. Frailty was assessed using the Edmonton Frail Scale: participants were deemed to be frail if their score was greater than or equal to 8. Dehydration was defined as either a serum sodium concentration greater than 145 mEq/L or a serum urea:creatinine ratio greater than 100.
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Assessment method [3]
303725
0
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Timepoint [3]
303725
0
calculated at point of presentation to ED
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Secondary outcome [1]
339951
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comparison of medication use between frail and robust participant groups by calculation of Drug Burden Index [ie comparison of mean numbers of medications used by frail vs robust participants]
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Assessment method [1]
339951
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Timepoint [1]
339951
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calculated at point of presentation to ED
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Secondary outcome [2]
340116
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comparison of proportions of frail vs robust participants with co-morbidities at the time of presentation to the ED: we will calculate percentages of all frail patients with co-morbidities for comparison with the percentage of all robust patients with co-morbidities
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Assessment method [2]
340116
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Timepoint [2]
340116
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The Charlson co-morbidity index will be calculated at the point of presentation to the ED
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Eligibility
Key inclusion criteria
above 60 years of age and have presented to the ED following a fall: able and willing to give informed consent
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Minimum age
60
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Below age of 60 years: presenting to ED for a reason other than a fall: unable or unwilling to give informed consent (including in the case of serious injuries)
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
comparison of proportions of frail vs robust participants with comorbidities
comparison of mean numbers of medications used by frail vs robust participants
comparison of rates of diuretic medication use by frail vs robust participants
comparison of rates of dehydration upon presentation among frail vs robust participants
comparison of incidence of diuretic medication use and rates of dehydration upon presentation by frail vs robust participants
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/06/2012
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Date of last participant enrolment
Anticipated
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Actual
30/03/2013
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Date of last data collection
Anticipated
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Actual
30/03/2013
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Sample size
Target
250
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Accrual to date
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Final
204
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
9208
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
17863
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2065 - St Leonards
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Funding & Sponsors
Funding source category [1]
297806
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Self funded/Unfunded
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Name [1]
297806
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unfunded
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Address [1]
297806
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unfunded
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Country [1]
297806
0
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Primary sponsor type
Individual
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Name
Alexander Bennet
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Address
Royal North Shore Hospital
Pacific Highway
St Leonards, NSW 2065
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Country
Australia
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Secondary sponsor category [1]
296838
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None
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Name [1]
296838
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nil
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Address [1]
296838
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nil
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Country [1]
296838
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298856
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NSLHD HREC
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Ethics committee address [1]
298856
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Kolling Building, Royal North Shore Hospital Pacific Highway St Leonards, NSW 2065
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Ethics committee country [1]
298856
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Australia
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Date submitted for ethics approval [1]
298856
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Approval date [1]
298856
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30/05/2012
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Ethics approval number [1]
298856
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Summary
Brief summary
Introduction: This study aimed to measure the prevalence of dehydration and diuretic use in older patients presenting to the Emergency Department of a large metropolitan hospital with falls. Materials and Methods: Subjects were recruited as a convenience sample from all patients aged over sixty years presenting with falls. The mean age of the 204 recruits was 81 years and 65% were female. Demographic, clinical, medication and falls information were collected on admission and the subjects were classified as either robust (101 subjects) or frail (103 subjects) utilising the Edmonton Frail Scale. Results and Conclusions: Compared to robust subjects, frail fallers were more likely to use diuretics (34% frail, 14% robust, p=0.001), to be dehydrated (20% frail, 7% robust, p=0.001) and to have both diuretic use and dehydration (13%, 3% robust, p=0.01). These findings suggest that dehydration, potentially exacerbated by diuretic use, is common amongst older patients admitted after a fall, particularly amongst the frail. These two factors, in the frail elderly in particular, merit further study as potentially modifiable causes of falls.
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Trial website
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Trial related presentations / publications
none
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Public notes
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Contacts
Principal investigator
Name
78458
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A/Prof Mark Gillett
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Address
78458
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Emergency Department
Royal North Shore Hospital
Pacific Highway
St Leonards
NSW 2065
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Country
78458
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Australia
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Phone
78458
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+61 2 9463 2228
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Fax
78458
0
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Email
78458
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[email protected]
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Contact person for public queries
Name
78459
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Mark Gillett
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Address
78459
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Emergency Department
Royal North Shore Hospital
Pacific Highway
St Leonards
NSW 2065
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Country
78459
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Australia
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Phone
78459
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+61299068123
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Fax
78459
0
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Email
78459
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[email protected]
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Contact person for scientific queries
Name
78460
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Mark Gillett
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Address
78460
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Emergency Department
Royal North Shore Hospital
Pacific Highway
St Leonards
NSW 2065
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Country
78460
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Australia
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Phone
78460
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+61457829396
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Fax
78460
0
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Email
78460
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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